Live Long and Well with Dr. Bobby

#57 Microplastics: potential problem with no easy solution

• Dr. Bobby Dubois • Season 1 • Episode 57

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Summary: Microplastics are showing up in our water, food, air—and in human tissues. In this episode, I unpack what the best studies actually show (and don’t), why risk is plausible but not proven, and the realistic steps you can take today without panic. 

In this episode, I cover:

  • What microplastics are and why they’re everywhere—from packaging and clothing to tire dust—and why production is still projected to rise ~70% by 2040 (OECD).
    OECD+2
    OECD+2
  • The signal that caught my attention: patients with microplastics in carotid artery plaque had a markedly higher 3-year risk of heart attack, stroke, or death (NEJM). Association, not proof—but concerning.
    The Guardian+3
    New England Journal of Medicine+3
    PubMed+3
  • What’s turning up in the brain: autopsy work suggests rising microplastic loads in brain tissue, though causality remains unknown (Nature Medicine coverage).
    Nature+2
    Nature+2
  • Everyday exposure: a liter of bottled water can contain ~240,000 plastic particles—mostly nanoplastics—using newer detection methods (NIH Research Matters).
    TIME+3
    National Institutes of Health (NIH)+3
    NCBI+3
  • Indoor vs. outdoor air: estimates suggest we inhale tens of thousands of microplastic particles daily, with higher indoor concentrations (PLOS One).
    PLOS+1

My takeaways for you (progress, not perfection):

  • Respect the signal without catastrophizing. Human data are early, but cardiovascular and neurologic signals merit attention.
    New England Journal of Medicine+1
  • Make the easy swaps: store food in glass, don’t microwave plastic, favor loose-leaf tea over plastic-based tea bags, and replace plastic cutting boards with wood or glass. (These trim exposure; they don’t eliminate it.) 
  • Air matters: consider a HEPA purifier for main living/sleeping areas and vacuum regularly; natural-fiber clothing sheds fewer synthetic particles. 
  • Water choices: where safe, use tap water with a quality home filter and a reusable (non-plastic) bottle—especially given the nanoplastic findings in some bottled waters.
    National Institutes of Health (NIH)

Listener corner: You asked for more quick-hit myth busters (yes, we’ll do “Does chicken soup speed recovery?”), and thanks for the reminder to wear a

SPEAKER_00:

Microplastics are everywhere in our water, our food, and yes, inside our bodies. A 2024 study found that patients who had microplastics in their brain arteries had a fourfold higher risk of heart attack, stroke, or death. But before you panic, let's look at what the science actually says, what we know, what we don't, and what you can realistically do about it. Hi, I'm Dr. Bobby Du Bois, and welcome to Live Long and Well, a podcast where we will talk about what you can do to live as long as possible and with as much energy and vigor that you wish. Together we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey, and I hope that you feel empowered along the way. I'm a physician, Iron Man triathlete, and have published several hundred scientific studies. I'm honored to be your guide. Welcome, my dear listeners, to episode 57. Microplastics, potential problem with no easy solution. Now, microplastics are everywhere, figuratively and literally, in the news, on social media, and hyped in ads selling you special water bottles and home air filters. And literally, microplastics are in what we breathe and in almost anything you can eat. How do we get here? Now, microplastics can't be good for you, but how worried should you be? And what, if anything, can we do? Let's find out where the evidence takes us. But before diving in, I want to share some listener feedback. When I did the episode on the five-second food rule, whether it's ODK to eat that French fry that fell on the floor, people really like that episode. And people said, please do more of them. And somebody recommended that I do one on chicken soup and whether it will help you get over your cold faster. So I've added it to the list. Another listener pointed out that I missed something, and I'm really appreciative of that listener. So when I talked about what we can do to reduce our risk of cancer, I mentioned suntan lotion and wearing long sleeve shirts to try to reduce the risk of skin cancer. But I forgot to mention wear a hat. And so many people do forget to wear a hat when they're in the sun. So thank you, listener, for pointing that out. And I love feedback. Send more. Positive, negative, it's all great. As always, please tell your friends. If you haven't, please write a review and send suggestions for how I can do a better job for you. As I've said, I'm trying to create a safe space for information. What does the evidence really tell us? I may be wrong at times, but I'm not driven by any financial motive, as I don't have sponsors, don't have paid subscriptions, and I don't own companies in this healthcare space at all. Okay, on to the good stuff. Part one: a bit of history about plastics, which may give you a sense of how the heck did we get here? So plastics originated in about 1907 with the creation of the first synthetic polymer, and it was called Bakelite. Over the ensuing decades, they started to make various items from this new plastic. But in World War II, that really ramped up, and many different aspects of military had plastics. The one you might think of as parachutes. They have nylon, which helps them. And why? Because it was lightweight, it was strong, and it could be mass-produced. Well, in the 1950s, there was an explosion in manufacturing of plastics and their use. So in the 1950s, there was about 2 million tons of plastic produced each year. Now we make about 500 million tons a year, and it's expected to increase by 70% over the next decade and a half. And here's a big number. There are 500 billion plastic bottles sold each year, and many of those do end up in the ocean. So why plastics? Well, they're cheap, they're light, they're durable, they're disposable, and compared to wood, glass, or metal, obviously, which are much heavier, more expensive, and generally not as disposable. We sleep on pillows filled with plastic, we use plastic toothbrushes, we type on plastic keyboards, we drink and eat from plastic containers, and we drive on tires made of plastic. It's in our disposable cups, it's throughout our coffee maker, except for maybe the thing at the bottom which collects the coffee, it's on our straws, it's in our house pipes, so plastics are everywhere. And to give you a punchline, it's kind of realistically unavoidable to remove them all from our lives. Okay, part two. What are microplastics? And, you know, frankly, how common are they? So they're different definitions, but microplastics are very small plastic particles, and they range from about five millimeters or a quarter of an inch or so, down to one nanometer, which is a really, really, really tiny size. Now, microplastics fall in two categories. One are called primary microplastics. This is where you create very small plastics for a very special purpose. So microbeads of plastic previously were in cosmetics, or we might find them in plastic glitter, or we might use them in various manufacturing processes. So here we're creating them in a very, very small size. The other, and probably the more common one, are secondary microplastics, and that's formed when we break down bigger plastics like bottles or tires that begin to wear away, or it even comes off our clothing, as we'll talk about. Now, plastics are everywhere, but microplastics, the breakdown of many of these plastics, are really everywhere. They've been found in the Antarctic tundra, they've been found in tropical coral reefs, they're in our air, they're in our food, they're in our beverages, and sadly, they're in most all of our tissues in the body. There was a 2018 study where they looked at 259 bottles of water from 11 brands from around the world. And what they found is of the 259 bottles, guess what? Only 17 of them had no microplastics. And the amount of microplastics in each of those bottles ranged from like 325 to 10,000. Okay, but it gets worse because there was a study not long ago that used a new technique to find even tinier, tinier microplastic particles down at the nanometer level. And what did they find? There were 240,000 pieces of this little tiny plastic per liter of water. Okay, now you might be thinking, all right, so maybe I should never drink water. Probably unavoidable, but you know, there's a thought. But they're in the air, too. And it's felt that we inhale about 68,000 tiny particles each day of microplastics. Now, here's a question for you before I give you the data. Do you think that microplastic exposure is worse outdoors or indoors? Think about this for a moment. You know, outdoors, you got all the air from cars and tires and all that kind of stuff. But indoors, you know, you got carpets, and and maybe because the air is kind of stale indoors, maybe there's more indoors. All right. Well, it turns out that the air outside has far fewer uh microplastics than indoors. Outdoors, maybe there's one particle per cubic meter, that's a meter on three sides, outdoors, and there's about a 50-fold higher amount indoors. People have estimated, and again, don't, you know, don't uh think this is absolutely proven because there are lots of different views and different arguments about this, but people kind of say we get about a credit card size amount of plastic in our bodies every week. Okay, so I hope I've shared with you, probably scared you, that plastics and microplastics are everywhere. So now the critical part is part three. What are the harms? Now, the body of literature on this to tell us how bad these are for us is really tiny. And they're all observational studies. So it's you know, they certainly didn't randomize people to say you're gonna get lots of microplastics and you're not. We're gonna wait 20 years and see who has problems. Now, of course, those kind of studies were never done. So, in these studies, I want to step back and share with you a saying that I may have said before with you and you may have heard, and that is the absence of evidence about harm is not the same as the evidence of absence of harm. Now, I know it's a little hard to grab that, so let me sort of break that down a little bit. Okay, so the absence of evidence means we don't have studies that really, really nail down the issue of harms. So that's the absence of evidence. Now, it may turn out that that this topic or other topics, you know, maybe there's a lot of harm, maybe there's very little harm, but we don't have good evidence. So we have the absence of evidence. Now, that's not the same as evidence of absence, meaning we have really good studies and they show us that there really aren't harms. So, why am I explaining this? So, if you don't have good studies, people might say, well, there's never been a study showing bad harm for microplastics. Again, you need to say to them, the absence of good evidence is not the same as the evidence of absence. So at the end of all this, there's going to be a lot of we're not sure. So, to give you an example of how really there's just not a lot of good studies out there, or any studies out there, there was a systematic review a year ago. And in that they found 28 animal studies. And you know how I feel about animal studies, um, but there were only three human observational studies. And the studies with people had like 40 people, 80 people. They weren't very big. So we really are lacking in a lot of information about this. But in the studies that have been done, they find microplastics in every part of our bodies, in our brain, in our blood, in our reproductive organs, in our GI tract, and even in the placenta. And people have talked about microplastics might affect our reproductive abilities, it might reduce sperm quality. Again, there's lots of theories, but not a lot of really definitive evidence in people. There are a couple of areas where we're starting to get some evidence, and it's pointing in a bit of a worrisome direction. First, the lungs. They've done studies where they take biopsies of lungs and they lavage the lungs, meaning they put fluid in our lungs, they suck it out, and they look at it under the microscope. But what they found is the microplastics go deep, deep, deep into the lung, likely in all the different nooks and crannies of your lung. And it's felt, now this is mostly done in vitro, meaning in the lab, not in people, that these little particles in the lung cause inflammation. And that will be a recurring theme that these particles might cause inflammation. Now, another aspect of kind of having it in our air, maybe in our lungs, comes from some interesting studies that they measured the amount of microplastics in the ocean. And they did it from various coastal communities. And it turned out that some of those coastal communities, the ocean had very little microplastics, and in other communities, again, ocean communities, the ocean had a lot more microplastics. So what did they find? They found that when those coastal cities had lots of microplastics in the ocean right there, there was a 10 to 20% higher risk of diabetes, heart disease, and stroke. Again, this is association. It may not tell us exactly what the answer is. Maybe in this places where microplastics were higher, people didn't exercise, they ate poorly, or any of a number of things. But it's suggestive that being exposed to that in those communities was problematic. Okay, now we're going to move to a different topic, and that's the brain. And here we're starting to get some uh data that worries me. I care about my brain, you probably care about your brain, we want to help our brain. So there was a really interesting study where they looked at autopsy findings. They looked to see were there microplastics in the brain on autopsy? And as you might anticipate, there's no way for us to know other than autopsies. You're not just going to take a bunch of folks and say, I'm going to drill a hole in your head, I'm going to take a biopsy and we'll see how much plastic is there. So they did this study where they looked at autopsies and they looked at them in 2016 and then in 2024. And they asked the question: are we finding more microplastics eight years later? Meaning, on the people who died, were they somehow having a larger burden, meaning that this problem is growing? What do they find? About a 50% increase in the amount of plastic in the brain between 2016 and 2024. That's not a good direction. We would like it to be going down, not up. When people have sort of guesstimated, well, how much plastic is in the brain, people say, well, maybe it's about a teaspoon size amount of plastic microplastics in the brain. Okay, now we're going to get to the Humdinger. This is the worrisome study. This is the one that keeps me up at night. Again, not a huge study, but they took 250 people who had a carotid end arterectomy. That's a surgery that goes into the blood vessels that enter your brain, that feed your brain, when they have plaque, when they have narrowing, and they scrape off the plaque so that there's more blood flow to the brain. And for certain people, it can reduce the risk of stroke. Okay. What did they find? They found that 150 of the 250 people had microplastics in the vessels that were feeding the brain. Okay, so you know, roughly two-thirds or so had microplastics in those parts of the vessels that they scraped off to make it the opening better. Then they followed people for three years after surgery. Now, here is what gets fascinating and worrisome. When you compared the patients who had the endororectomy, but there was no microplastics in the plaque versus the people that did have microplastics. The people with microplastics had a over four-fold increased risk of a heart attack, a stroke, or death. So what that means was not only did the plaque that had microplastics that was feeding the brain cause brain concerns, it also caused heart concerns. Now, is that because there was inflammation that went to the heart? Did it um does it reflect that, well, if they had microplastics in their brain arteries, they probably had it in their heart arteries. We don't know. Again, this is not a randomized trial, but it's very worrisome that the only difference between these patients that we know of that had the carotid procedure was whether they did or didn't have plastics there. And again, a huge increased risk of bad things. Okay, now, where are we now? We're at part four. We've talked about what plastics are, we've talked about how common they are, and we've talked about the data that suggests they're harmful. Okay, now what can we do? The solution section to this episode. Well, there are some solutions. The problem is none of them are very easy, and probably none of them are really going to work. So sorry about that, but here is what we know. There's really two ways to come at this. One is what could public policy, what could government, what could governments around the world do to help this problem? And so there have been discussions around well, let's limit the production of plastics. Let's eliminate single-use plastics like gloves or fast food containers or grocery bags or water bottles. And if we eliminate that, then they won't go into the ocean, they won't break up, they won't end up in our food. Or you could ban certain products, like those microbeads and cosmetics. Um, or you could ask manufacturers to make sure that they can recycle things so that they might not have quite such a burden of microplastics on the environment. Or you could require that tires in cars be made a bit differently so that they didn't shed as much microplastics. Well, a few years ago, they brought together 175 countries to sign an agreement that would really bring into place many of the things I just talked about. Well, those negotiations fell apart in 2025. So it's not really clear where this is going to go. In California, they did have a bill to basically uh require that all food packaging be recyclable. Other states are thinking about banning styrofoam uh um uh food containers. So there's a variety of different policy approaches. Here's an interesting and perhaps uh uh unexpected uh data point. Many people say to save our environment, we need to drive electric vehicles. Well, it turns out electric vehicles, of course, have tires. Regular vehicles have tires. Electric vehicles, because they have all these batteries, are much heavier. And so they wear out tires more rapidly than a conventional gas car. What does that mean? There's more microplastics coming off the tires of an electric vehicle than a gas-powered one. So, again, no simple solutions. All right. So, what are the personal approaches that you might take? So maybe you know, government isn't about to step in. And I do ask the question: if we got rid of the single-use stuff, we're not saying we're going to do away with tires. We're not going to say we're going to do away with all plastics. So it's not clear to me, even if they pass that, what percentage of microplastics would be reduced? And would that reduction, whether it's 10%, 30%, whatever it is, would that really make a difference? So, what can you do personally at home? Well, you can avoid bottled water, or at least water that comes in plastic. Cutting boards are actually a big source of microplastics. Every time you cut a carrot on a plastic um cutting board, it causes microplastics into the air. Avoid microwaving plastic containers. Try to store food in glass containers. Here's one. Use um loose tea because tea bags actually are made from uh plastics. And when they're dunked in the hot water, it releases microplastics. You know, bring your mug to work so you don't have to use disposable things. Perhaps considering a home filter, like a HEPA air filter, vacuum regularly to try to get stuff up and out. And wear clothes that are 100% natural, cotton or wool, because all the synthetics or the synthetic cotton wool blends have obviously microplastics that will shed from them. But again, I come back to this issue of even if you avoided all of these, you're gonna go outdoors, you're gonna get in your car, you're gonna be breathing a lot of microplastics, and you're gonna end up with food and water that has microplastics. So I'm not sure you can really get rid of a substantial percentage. All right, let's wrap up. Microplastics are everywhere in our environment, and sadly, they're in our bodies. Now, they can't be good for you. I can't imagine a world where we would say microplastics in our body is a good thing. Now, how harmful they are isn't absolutely clear. Sure, I shared some information that it goes deep into the lungs, it gets into the brain, and that it may increase the risk of heart attack, stroke, or death. But we really don't know yet. It's an early phase of analysis. Can you reduce exposure? You can try to, but whether that's realistic that you can reduce enough, I'm just not sure. So, as always, I hope you live long and well. Think about microplastics, try what you can, and hope that it reduces the risk sufficiently. Until next time, goodbye. Thanks so much for listening to Live Long and Well with Dr. Bobby. If you like this episode, please provide a review on Apple or Spotify or wherever you listen. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at Dr. Bobby Livelongandwell.com. That's doctor as a dr bobby live longandwell.com.